Sunday, March 22, 2015

I'm just back from a week off in which I did not do nearly enough relaxing. Nor did I get to my computer - I left it at home!

I've been talking about expanding "utterance" length in aac users, which is much like what you do with verbal students. What you do to develop language is not different. Only the mode of input (adding use of the aac system when you speak) and mode of output (the student using his or her aac system to respond) are different.

One other consideration is the level of decontextualization and egocentrism. For many students - particularly those with developmental disabilities - generalization is difficult and providing activities that have little personal meaning or context is not effective. So providing intervention in natural situations is important.

If you can't be in the midst of naturally occurring events, create them. Many SLPs create role model situations, have "pretend" birthday or tea parties, and find other ways to create a realistic context for intervention.

So, back to our target: increased symbol sequences.

Creating 2-3 word phrases with adjectives adds to the meaning of the communication significantly. Again, keep in mind that our goal in communication with students using aac is not significantly different from our goal in developing language skills with other students. We’re looking at teaching the students how to generate language responses for communication.

At the 2-word level of language development, forms and functions include requesting with want, get, or find, what, where, and why. Also negation increases with with no, all gone, away, and stop. And then there is association or attribution, describing or specifying by using adjectives. Big, little, that, this, and color words come into use to help the listener understand.

Students can also begin to answer questions in context, using 1-3 symbol sequences:

At the 3 word level, students are expanding their noun phrases with adjectives and other modifiers and demonstratives. "I want big." "Put it down." "It big blue." "Want you stop." "I want more."

We'll talk some more next week about strategies. I should be back in work mode by then - I hope!

Sunday, March 8, 2015

In teaching and talking about teaching AAC use, a lot of time is spent on deciding which should be the first words taught to an aac user. First words for aac use, as a topic, has gotten a lot of “airplay,” as it were.

Less time has been spent on talking about where to go from there. Because so many young aac users have a variety of language disorders and differences, more time has been spent talking about increasing the variety of communication functions a child/student uses, and this is definitely a good thing. But while we’re at it, we need to think about the ‘form’ of the language, as well as the ‘content.’

In graduate school, we learn that form refers to the rule-based aspects of language, content refers to the meaning of language, and use refers to the social conventions - or pragmatics - of language.

We all should know by now that beginning vocabulary instruction with young nonverbal children should not begin and end with teaching the names of objects that they want to ask for. I love Janice Light’s admonishment; “There is more to life than cookies.” Having spent way too many years teaching kids with autism the names, signs, or pictures for concrete things they could ask for (M&Ms come to mind, alas), I know full well that the behavioral issues that come with not being able to communicate are rarely, if ever, alleviated by a handful of M&Ms.

Much research has been done on language development in general, and on the acquisition and use of early words; especially those words we know of as “core words.” The teaching of core vocabulary to aac users is becoming more widespread and has moved beyond the work of Bruce Baker and users of PRC devices.

But, somehow, we often seem to get stuck with those first 15, 25, or 32 core words. Even SLPs forget about 2-word combinations when teaching aac users. But isn’t that the natural place to go?

I spend a lot of time convincing SLPs who have not previously worked with aac and suddenly find themselves with a student who needs aac on their caseload, that they really do not need to do very much differently. Language development is language development. Language disorders are not significantly different across students. Vocabulary instruction is vocabulary instruction. The mode of communication may be different, and that requires an extra step or two in the process, but…. Yes, you can do the same things you’ve been doing. Teaching strategies differ. Materials differ. But the structure of language doesn’t necessarily differ at this atge.

I also spend time watching those same SLPs become triumphant when they realize that it does work and ….. Look! He’s putting two words together.

Two word combinations are necessary to convey meaning when one of those words is a noun. “Apple.” Well, what about an apple? Do you want an apple? Did your apple fall on the floor? Did someone take your apple? Are you tired of apples?

But think of the magic of communication when combining two core words. All of the multiple meanings of both words create powerful combinations. “Want apple.” “Not apple.” “Give apple.” “Bad apple.” Good apple.” “More apple.” I’ve made meaning intelligible, and I’ve covered - how many functions??

I’ve included here a list of the 25 core words of toddlers, from the original Benajee, DiCarlo, Striklin (2003) study. Next week, I’ll talk about some strategies for increasing those single word “utterances” to beginning phrases. But I’ll bet you already know them.

Sunday, March 1, 2015

From day one, we should be talking about the elements of a story when we’re reading. Pointing out the characters, setting, and events is natural as you read and discuss a book. Building the understanding in children that the book is about someone, somewhere, doing something gives them the basis for understanding narratives of all sorts, either personal or fictional. One of the very simplest story frames that has been used for years is the very basic:

Somebody (the character)

Wanted (the initiating event)

But (the problem)

So (the events and ending)

For the book “Stone Soup” your very simple story frame might look like this:

Somebody - the soldiers

Wanted - to eat

But - the peasants hid the food

So - the soldiers tricked them into making “stone” soup

Another way to build understanding is to talk about the WHO (the characters) the WHERE (the setting) the WHAT Happened (the plot) as the very first step. I love MaryEllen Rooney’s Story Grammar Marker and have used it for years with lots of kids (visit http://MindWingConcepts.com ).

Since I’ve already talked about sequences by the time I get to identifying story elements and/or re-telling the story, my work is half-way done by now.

I use lots and lots of visual cues with the kids I work with, and it makes all the difference! I often run into teachers or parents who feel the visual cues are for younger kids, or just aren’t needed, but I’m still using visual cues when I work with adults and, yes, they really are necessary.

Here is a “story element die” that I used a lot in intervention. You can have students take turns rolling the die and telling the part of the story that shows up, or use it in story telling or personal narrative building. It’s also great in history - which is basically story re-telling.

So, who am I?

As a speech-language pathologist for almost 40 years, I am passionate about giving other SLPs, parents, special education teachers the tools they need to implement AAC with fidelity and evidence based practices. I have worked with kids and adults with a wide range of disabilities; especially kids with autism. I have also worked in the public schools with kids with significant language learning disabilities. I give workshops, provide training to school district staff, speak at national conferences, and provide evaluations for speech-language and AAC.

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